Cognition as a predictor of social network size and early communication in clinically high risk for psychosis individuals.

Social networks provide critical support, yet individuals at clinical high-risk for psychosis (CHR) often experience deficits in social functioning and have smaller networks compared to healthy controls (HCs). Cognitive impairment, a hallmark characteristic of this group, may be associated with these challenges. This study is the first investigation into the relationships between general and specific domains of cognition and social network and communication abilities in people at CHR. The sample included 91 participants (HC = 43, CHR = 48) with complete cognitive and social network assessments from the same visit, with additional analyses including guardian ratings of social responsiveness and communication. Cognitive ability was significantly associated with social network size in both groups (b = 0.38,  < .0001), with significant contributions from working memory (b = 0.29,  = .004), speed of processing (b = 0.23,  = 002), verbal learning (b = 0.24,  = .007), and social cognition (b = 0.25,  = .012). Higher scores on cognitive functioning correlated with better social reciprocity (b = 1.28,  = .009) and fewer communication difficulties (b = 0.25,  < .002). Processing speed was particularly relevant to both social responsiveness (b = 0.88,  < .022) and communication difficulties (b = 0.12,  < .03). An interaction effect revealed that associations between cognitive ability on communication skills were more pronounced in CHR individuals compared to HCs (b = 0.26,  < .037). These findings underscore the potential role of specific cognitive domains, such as processing speed, in social functioning among CHR individuals. Future research should examine the directionality of these relationships to better understand underlying mechanisms of social functioning impairments and inform treatment development.